PORTLAND, Ore. (CN) – A federal class action claims that USAA insurance cheats military families of medical treatment for auto-accident injuries. The class claims the insurer uses “fraudulent file reviews in order to deprive plaintiffs, and those like them, of their medical treatment and thereby save USAA money at the expense of servicemen and women, and their families.”
The four named plaintiffs, all women, are on active duty, or the daughter or wife of a servicewoman or serviceman who are military veterans or on active duty. All say USAA Casualty Insurance or one of its clones refused to pay legitimate claims for medical expenses after auto accidents.
Defendants include USAA Casualty Insurance Co., United Services Automobile Association, USAA General Indemnity Co., USAA County Mutual Insurance Corp., Garrison Property and Casualty Insurance, Auto Injury Solutions Inc. and chiropractors Clark Wolf III and Ross Hart.
Plaintiff Margaret Soukup, on active duty, says she was “induced into” hiring USAA as her primary insurer for her and her family.
“USAA touted its commitment to servicing military families and advertised the ‘exclusive privileges of its auto insurance,’ noting that, ‘For those who stood tall for this country and for their families, we stand ready to return the favor,'” the complaint states.
After she was injured in a rear-end collision, and submitted a claim for personal injuries, she says that without her knowledge, USAA referred her claim to Auto Injury Solutions (AIS), which prepared “sham file reviews” that USAA uses to “uniformly conclude that medical treatment was not needed.”
Brittney Bathurst, the daughter of a military veteran, says she was nearly killed in a “T-bone” collision in Minnesota, and that USAA referred her claim to AIS, which “prepared a sham file review, purportedly created by a Leslie Kancir, an acupuncturist located in Lakewood, Colorado.”
Bathurst says Kancir’s signature on the bogus file review was “an ‘electronic’ signature;” that “the report states in no uncertain terms that ‘A Physician Review has been completed;'” and that that statement “is absolutely false.”
Amber DeMerritt says she was injured in Oregon, and USAA and AIS cooked up “at least four sham file review reports, purportedly created by a George D. Sage, a chiropractor in Decatur, Georgia.”
Samantha Jones says the defendants created “nine sham file reviews” and used them to deny her coverage.
They seek punitive damages for the class, for breach of contract, breach of faith, and violations of insurance laws and regulations. They are represented by Daniel Gatti and Ron Sayer with Gatti Gatti Maier Sayer Thayer & Smith, of Salem, Ore.